RESEARCH - Blockade of TNF-alpha alters IgG and IgA RF in patients with RA

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Ann Rheum Dis. 2005 Aug;64(8):1224-6.

Blockade of tumour necrosis factor {alpha} significantly alters the serum

level of IgG- and IgA-rheumatoid factor in patients with rheumatoid

arthritis.

Yazdani-Biuki B, Stadlmaier E, Mulabecirovic A, Brezinschek R, Tilz G, Demel

U, Mueller T, Brickmann K, Graninger WB, Brezinschek HP.

Division of Rheumatology/Department of Internal Medicine Medical University

Graz Auenbruggerplatz 15 A-8036 Graz, Austria.

OBJECTIVE: To determine the effect on the humoral immune system of long term

treatment of patients with RA with etanercept. METHODS: 12 consecutive

patients with seropositive RA treated with etanercept were studied and

followed up for 9 months. Clinical efficacy of treatment was evaluated using

the 28 joint count Disease Activity Score (DAS28). Serum samples were

collected at baseline and after 9 months and serum immunoglobulin, RF

isotypes, and anti-cyclic citrullinated peptide (aCCP), antinuclear,

nucleosome, and dsDNA antibodies determined. For comparison 7 patients with

seropositive RA treated with adalimumab were studied. RESULTS: DAS28

decreased significantly after the first month and then was constant for the

whole study (5.7 (0.3) v 3.8 (0.2), p< or=0.000). Serum IgA-RF and IgG-RF

increased significantly after 9 months' etanercept treatment (mean (SEM)

IgA-RF rose from 19.5 (4.8) to 30.5 (5.9) IU/ml, p< or=0.01; IgG-RF from

20.6 (8.1) to 33.8 (11.5) IU/ml, p< or=0.04). Serum levels of total

immunoglobulin and specific autoantibodies remained unchanged during the

study. In patients treated with adalimumab, no significant changes in serum

levels of RF isotypes and aCCP antibodies were seen.

CONCLUSION: Etanercept, although effective in treating the clinical symptoms

of RA, seems to have a pivotal effect on RF-producing B cells either

directly or indirectly.

PMID: 16014683

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6014683 & dopt=Abstract

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